physiological third stages? do they happen in your trust?

syntometrine
I can spell when I put my mind to it

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yeah sarah it does, I think it's the effect of the ergometrine (syntometrine=syntocinon and ergometrine mix) but many women will feel very sick or vomit after they have had the injection, it's quite common and not very pleasant fo the poor woman. Unfortunately i have never heard this discussed.

It can also have other effects, like causing blood pressure to shoot up, which is why PET patients etc aren't given the mixture, just the syntocinon, hope that helps xxxx

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"With my hands, i have felt the strength it takes to grow, and release new spirit......."
"All the best births are the ones where you only have time to record times on a paper towel..."- a midwife, somewhere in the middle

In my area there seems to have been a switch to syntocinon as the oxytocic of choice - not sure if this is being echoed at other Trusts around the country?

I'm yet to see a physiological third stage. The one time a woman consented my midwife and I both forgot - we were so conditioned to giving the synto that we did it on auto-pilot. Thankfully the woman was completely understanding about it!

I find that getting synto consent out of the way is just one aspect of the admission procedure, and more often than not it is in the vein of, "are you happy to have the injection in your leg to get the placenta out?" I think this is going to be something that I write into my objectives for my Labour Suite placement when I return after the holidays. I think this is a good way to get practice obtaining true informed consent, by giving good up-to-date info about the pros and cons, and by discussing this with your mentor before you start you avoid any confrontation... I'm going to put a post-it on my Assessment in practice document now!!! lol

We had a great class about 3rd stage, and one of the things the lecturer said is that although you can bleed more immediately after delivery of the placenta with a physiological third stage, overall the blood loss after delivery is comparable with an actively managed third stage, as the Lochia is often reduced in the postpartum period with physiological management. Not sure if anyone else has heard that, and a reference would be good to wield against the cynics!!!

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